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Organization
TYSON C. COBB, M.D., INC
Active
Organization
TYSON C. COBB, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYSON C. COBB M.D (OWNER)
(714) 564-3300
Entity
Organization
Contact information
Practice address
1140 W LA VETA AVE, SUITE 640, ORANGE, CA 92868-4223
(714) 564-3300
(949) 231-5112
Mailing address
1140 W LA VETA AVE, SUITE 640, ORANGE, CA 92868-4223
(714) 564-3300
(949) 231-5112
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C35334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710982061
MEDICARE NPI
CA
Enumeration date
02/06/2009
Last updated
08/20/2010
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